This Kaiser Commission on Medicaid and the Uninsured video segment returns to the plaintiffs of the Olmstead case five years after the landmark U.S. Supreme Court decision. It reports on the impact of the decision for individuals with disabilities and some of the challenges that remain in the implementation of…
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Medicaid Long-Term Services and Supports: Key Considerations for Successful Transitions from Fee-For-Service to Capitated Managed Care Programs
Although relatively few Medicaid beneficiaries are in capitated managed long-term services and supports (LTSS) programs, significant expansion is anticipated as more than half of states are implementing or proposing new programs that would include a transition from fee-for-service (FFS) to capitated managed care in the LTSS delivery system. By definition,…
Amid increasing state and national interest in using managed care delivery models for Medicaid beneficiaries, the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) hosted a public briefing on Tuesday, June 25, 2013 to provide information on recent transitions from fee-for-service to managed care, and to discuss their…
This brief examines the role of Medicare and Medicaid in the lives of dually eligible beneficiaries – low-income seniors and younger adults with disabilities who are eligible for both programs – through personal profiles. It includes a glossary of eligibility and service delivery system terms and state-level enrollment and expenditure data for dual eligibles.
Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Insights from California
This brief examines how health service providers, plan administrators, and community-based organizations in Contra Costa, Kern, and Los Angeles Counties experienced the transition of Medi-Cal-only seniors and persons with disabilities (SPDs) to managed care as part of the state’s “Bridge to Reform” Medicaid waiver. Findings presented may inform similar transitions of high-need beneficiaries in other states and coverage expansions in 2014 under the Affordable Care Act.
This report projects the impact of the new Medicare drug benefit on out-of-pocket spending for people who enroll in 2006. This analysis from November 2004 estimates that 6.9 million beneficiaries are projected to be affected by the coverage gap (the so-called “doughnut hole”) in the standard Part D drug benefit.…
The Medicare program offers health and financial protection to nearly 50 million seniors and younger people with disabilities, though many beneficiaries still face significant out-of-pocket expenses. This analysis examines how much Medicare households spend on health-related expenses compared to other spending priorities and compared to non-Medicare households, the extent to which Medicare households’ health spending as a share of household budgets varies by age and poverty level, and changes in Medicare households’ health spending over time.
Helping Consumers Manage Long-Term Services and Supports in the Community: State Medicaid Program Activities
The Medicaid program is a source for many innovative practices in making long-term services and supports (LTSS) available to consumers. Jointly financed by the states and the federal government, Medicaid pays for 40 percent of LTSS spending the United States. Case management services have been integral to Medicaid community-based LTSS…
One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.
Olmstead’s Role in Community Integration for People with Disabilities Under Medicaid: 15 Years After the Supreme Court’s Olmstead Decision
June 2014 marks the 15th anniversary of the United States Supreme Court’s landmark civil rights decision in Olmstead v. L.C., finding that the unjustified institutionalization of people with disabilities is illegal discrimination. This issue brief examines the legacy of Olmstead, with an emphasis on legal case developments and policy trends emerging in the last five years and the related contributions of the Medicaid program.